Successful Combined Treatment of Giant Carotid Body Tumor with Embolization Applied before Surgery

Usta, Hakan; Jalalzai, Izatullah; Borulu, Ferhat; Çalık, Eyüp Serhat; Erkut, Bilgehan

doi:10.3400/avd.cr.21-00011

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…There are few reports on MRI in the diagnosis of CBTs. MRI delineates the extent of a tumor, its vascularity, the condition of the carotid vessels, and the presence of other swellings or enlarged nodes and is a good alternative to CT [ 7 ].…”

Section: Case Historymentioning

confidence: 99%

A Case Report of a Bilateral Carotid Body Tumor and a Review of Its Imaging Manifestations

Xu¹,

Kang²,

Wen³

2023

Journal of the Belgian Society of Radiology

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Bilateral carotid body tumors (CBTs) are extremely uncommon. In recent years, some clinical cases have been documented. A case of bilateral CBT is reported with a review of its imaging manifestations. When a unilateral CBT is discovered, assessment of the contralateral site is essential. The 'goblet' sign is a characteristic imaging feature of CBT. The preferred imaging modality is computed tomography angiography.Teaching Point: When a carotid body tumor is suspected on one side, careful examinationof the contralateral side is essential; The preferred imaging approach is CTA.

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Section: Case Historymentioning

confidence: 99%

A Case Report of a Bilateral Carotid Body Tumor and a Review of Its Imaging Manifestations

Xu¹,

Kang²,

Wen³

2023

Journal of the Belgian Society of Radiology

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“…Carotid body tumors (CBT) are highly vascular, glomus tumors arising from paraganglion cells of the carotid body. They represent only 0.6% of head and neck tumors and are usually benign with a metastasis rate of 2%–9% 1,2 . While they are usually benign, the location and growth of these tumors can lead to symptoms of enlarging neck mass, dysphagia, voice changes, headache, syncope, Horner syndrome, and compressive symptoms of cranial nerves IX, X, XII and the sympathetic chain 1 .…”

Section: Introductionmentioning

confidence: 99%

“…They represent only 0.6% of head and neck tumors and are usually benign with a metastasis rate of 2%–9% 1,2 . While they are usually benign, the location and growth of these tumors can lead to symptoms of enlarging neck mass, dysphagia, voice changes, headache, syncope, Horner syndrome, and compressive symptoms of cranial nerves IX, X, XII and the sympathetic chain 1 . Most CBT's are nonfunctional, but catecholamine‐producing tumors are possible leading to symptoms of paroxysmal hypertension 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Reducing intraoperative blood loss and incidence of cranial nerve deficits is crucial in large tumors. Pre‐embolization of CBTs can be helpful in decreasing blood loss and reducing risk for cranial nerve deficits by reducing the number of feeding arteries to the vessel 1,2 . However, embolization presents with risks, including local inflammation, neural damage, and a 3% risk of downstream emboli 7,8 .…”

Section: Introductionmentioning

confidence: 99%

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Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience

Wong,

Tam,

Tran

et al. 2023

Laryngoscope Investig Oto

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ObjectiveTo evaluate the effects and outcomes of multidisciplinary surgical approaches in the management of carotid body tumors (CBT).MethodsA single‐center retrospective study at the University of California—Los Angeles Medical Center was conducted on patients who presented with CBTs and underwent surgical resections from 1998 to 2020. Statistical analysis was performed using IBM SPSS v27 and Excel.ResultsA total of 75 patients with 79 CBT resections were included. Operating surgical subspecialties included: 41.8% vascular surgery, 24.1% otolaryngology head and neck surgeons (OHNS), and 31.6% combined OHNS and vascular. 68.4% of tumors underwent preoperative embolization. EBL was directly correlated with tumor size. CBT size was similar for OHNS (30 mm) and vascular (31 mm) but was significantly larger for combined OHNS and vascular cases (38 mm). EBL was higher in combined cases (301 mL) compared to OHNS (124 mL) or vascular (203 mL) alone. Incidence of postoperative cranial nerve deficits was 7.8%, with combined OHNS and vascular cases having an incidence of 4.0% when compared to OHNS (5.3%) versus vascular surgery alone (12.1%).ConclusionCBTs can be managed effectively by single surgical specialties with similar outcomes between vascular surgery and OHNS. In larger, higher grade tumors, however, a combined vascular and OHNS approach had lower incidence of postoperative cranial nerve injuries when compared to single specialty resections, despite a larger EBL. Thus, a multidisciplinary surgical approach suggests favorable outcomes with fewer incidence of cranial nerve deficits for larger, more complex CBT resections.Level of Evidence2b—Individual retrospective cohort study.

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“…Preoperative transarterial embolization (pre-TAE) decreased the overall blood loss (BL) and improved visualization at surgery, thus facilitating tumor resection, which was first introduced by Schick et al in 1980 (9). Since then, several studies have evaluated the impact of pre-TAE on CBT surgery (4,(10)(11)(12)(13)(14)(15)(16)(17). The results demonstrated that pre-TAE is an effective and safe adjunct for surgical resection that can reduce BL and operative time during surgery and decrease the risk of perioperative complications, especially for Shamblin class II/III tumors.…”

Section: Introductionmentioning

confidence: 99%

Beneficial effects of preoperative superselective embolization on carotid body tumor surgery: A 13-year single-center experience

Yuan

Chen

et al. 2022

Front. Oncol.

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PurposeThis study presented our 13-year experience managing patients with CBTs (carotid body tumors) and was aimed to investigate the impact of pre-TAE (preoperative transarterial embolization) on CBT surgical resection.MethodsThis retrospective study reviewed 169 surgically excised CBTs between May 2007 and October 2020. According to whether to carry out the pre-TAE, the patients were classified into the embolization (EG) (n = 130) and non-embolization groups (NEG) (n = 39). Tumor classification was based on Shamblin criteria and tumor size. The demographic data, clinical features, and intraoperative and postoperative information about the patients were retrieved and analyzed.ResultsThe average tumor size was (43.49 vs. 35.44 mm, p = 0.04) for EG and NEG. The mean surgical time (195.48 vs. 205.64 mins, p = 0.62) and intraoperative BL (blood loss) (215.15 vs. 251.41 cc, p = 0.59) were less, but the incidence of revascularization required (29% vs. 33%, p = 0.62) and total complications (26% vs. 36%, p = 0.32) were lower in EG compared to NEG. Similarly, according to the subgroup analysis, no significant differences were detected in the surgical time, BL, adverse events (AEs), and the revascularization in EG when compared to NEG for type I (n = 5 vs. 7), II (n = 105 vs. 27), and III (n = 20 vs. 5), respectively except for the surgical duration in type III (p < 0.05). However, a significantly lower incidence of AEs (230.25 vs. 350 cc, p = 0.038) and a decline in BL (28.57% vs. 48.15%, p = 0.049) in EG were observed compared to those in NEG patients for large CBTs (≥ 30 mm as the cutoff point). No surgery-related mortality was observed during the follow-up.ConclusionsCBTs can be surgically resected safely and effectively with a need for pre-TAE, which significantly decreases the overall BL and AEs for large lesions (≥ 30 mm).

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Successful Combined Treatment of Giant Carotid Body Tumor with Embolization Applied before Surgery

Cited by 4 publications

References 10 publications

A Case Report of a Bilateral Carotid Body Tumor and a Review of Its Imaging Manifestations

A Case Report of a Bilateral Carotid Body Tumor and a Review of Its Imaging Manifestations

Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience

Beneficial effects of preoperative superselective embolization on carotid body tumor surgery: A 13-year single-center experience

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